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Journal of Obesity
Volume 2013 (2013), Article ID 952916, 9 pages
Review Article

The Role of Adipose Tissue in Insulin Resistance in Women of African Ancestry

1UCT/MRC Research Unit for Exercise Science and Sports Medicine, South African Medical Research Council, Parow, Cape Town 7505, South Africa
2UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Health Sciences Faculty, University of Cape Town, Cape Town 7725, South Africa
3Endocrine Unit, Department of Medicine, University of Cape Town, Cape Town 8001, South Africa
4Health Impact Assessment, Western Cape Department of Health, Cape Town 8001, South Africa

Received 9 November 2012; Accepted 13 December 2012

Academic Editor: Manisha S. Chandalia

Copyright © 2013 Julia H. Goedecke et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Women of African ancestry, particularly those living in industrialized countries, experience a disproportionately higher prevalence of type 2 diabetes (T2D) compared to their white counterparts. Similarly, obesity and insulin resistance, which are major risk factors for T2D, are greater in black compared to white women. The exact mechanisms underlying these phenomena are not known. This paper will focus on the role of adipose tissue biology. Firstly, the characteristic body fat distribution of women of African ancestry will be discussed, followed by the depot-specific associations with insulin resistance. Factors involved in adipose tissue biology and their relation to insulin sensitivity will then be explored, including the role of sex hormones, glucocorticoid metabolism, lipolysis and adipogenesis, and their consequent effects on adipose tissue hypoxia, oxidative stress, and inflammation. Finally the role of ectopic fat deposition will be discussed. The paper proposes directions for future research, in particular highlighting the need for longitudinal and/or intervention studies to better understand the mechanisms underlying the high prevalence of insulin resistance and T2D in women of African ancestry.